COMPARISON OF LONELINESS AND SOCIAL NETWORK BETWEEN OLDER ADULT CAREGIVERS AND NONCAREGIVERS

Abstract In ageing societies, more older adults are taking up informal caregiving roles. Caregivers, compared to non-caregivers, are found to have poorer psychosocial outcomes such as loneliness and social isolation in various studies. However, most of this research is not specific to older adult caregivers and does not account for selection bias into caregiving. We compare loneliness and social network between older adult caregivers and older adult non-caregivers in Singapore, applying inverse probability weighted regression adjustment (IPWRA), to address selection bias into caregiving, on data from a nationally representative longitudinal study of older adults. Those providing unpaid assistance to any person because of their health condition were considered as caregivers. Loneliness (score: 0-12; higher score=lonelier) and social network (0-60; higher score=greater network) were measured using validated scales. The relationship of caregiving status with loneliness and social network was estimated using IPWRA, controlling for multiple demographic and health characteristics. Of the 2639 respondents, 7.2% were caregivers. Older adult caregivers, versus non-caregivers, were more likely to experience loneliness (average treatment effect [ATE] β-coefficient for loneliness score: 0.328 (95% confidence interval: 0.011-0.645; p-value: 0.042); and odds ratio for being lonely: 1.080 (1.001-1.165); p-value: 0.047). However, they did not differ in terms of their social network (ATE β-coefficient for social network score: 1.456 (-0.405-3.316); p-value: 0.125). Our findings suggest that even with a similar extent of social network, older adult caregivers are at a higher risk of loneliness, i.e., perceived social isolation or relational deficits, compared to non-caregivers.

When considering the public health ramifications of family caregiving, a major concern is the future supply of family, friends, or other unpaid caregivers (hereafter referred to as family caregivers) of older persons with health needs.This presentation will summarize the state of the science on estimating the future "supply" of family caregivers for older persons, and whether there are structural or social determinants, in addition to long-standing socio demographic trends, which may contribute to the family care gap.In addition, the presentation will outline a potential research agenda on the family care gap that summarizes the potential implications of this phenomenon as well as how it aligns with efforts to elevate family caregiving for older people (particularly those living with dementia) as a matter of public health import.

SUPPORT EXCHANGES IN COUPLES COPING WITH EARLY-STAGE ALZHEIMER'S DISEASE
Meng Huo 1 , and Kyungmin Kim 2 , 1. University of California,Davis,Davis,California,United States,2. Seoul National University,Seoul,Republic of Korea People living with Alzheimer's disease (AD) typically receive considerable support from their spousal caregivers.Yet, we know little about whether people with early-stage AD may still be able to help their caregivers and how potential support exchanges in these couples may vary depending on the quality of their relationships.We drew on dyadic data from 37 older couples in which one partner lives with mildto-moderate AD (Mage = 77yrs, 48% male) and the other serves as a spousal caregiver (Mage = 76yrs, 53% female).Couples participated in concurrent interviews during which they each reported on a variety of demographic and relationship characteristics, such as relationship quality, and couple support exchanges.People with early-stage AD perceived their relationships with spousal caregivers as more positive and less negative than did these caregivers.Support did not flow unidirectionally in these caregiving couples, especially not among those in better-quality relationships.Specifically, caregivers who viewed their relationships as more positive/ less negative considered it less stressful to provide emotional and practical support to their partners with AD.Patients who viewed their relationships as more positive/less negative provide more frequent emotional and practical support to their caregivers and also found such support provision more pleasant and less stressful.Findings reveal positive contribution that older adults with dementia, who have been solely treated as recipients of care, can make and shed light on the development of dyadic interventions by highlighting the importance of mutually beneficial relationships in early stages of AD.
Ting Yong, Abhijit Visaria, and Rahul Malhotra, Duke-NUS Graduate Medical School, Singapore, Singapore In ageing societies, more older adults are taking up informal caregiving roles.Caregivers, compared to noncaregivers, are found to have poorer psychosocial outcomes such as loneliness and social isolation in various studies.However, most of this research is not specific to older adult caregivers and does not account for selection bias into caregiving.We compare loneliness and social network between older adult caregivers and older adult non-caregivers in Singapore, applying inverse probability weighted regression adjustment (IPWRA), to address selection bias into caregiving, on data from a nationally representative longitudinal study of older adults.Those providing unpaid assistance to any person because of their health condition were considered as caregivers.Loneliness (score: 0-12; higher score=lonelier) and social network (0-60; higher score=greater network) were measured using validated scales.The relationship of caregiving status with loneliness and social network was estimated using IPWRA, controlling for multiple demographic and health characteristics.Of the 2639 respondents, 7.2% were caregivers.Older adult caregivers, versus non-caregivers, were more likely to experience loneliness (average treatment effect [ATE] β-coefficient for loneliness score: 0.328 (95% confidence interval: 0.011-0.645;p-value: 0.042); and odds ratio for being lonely: 1.080 (1.001-1.165);p-value: 0.047).However, they did not differ in terms of their social network (ATE β-coefficient for social network score: 1.456 (-0.405-3.316);p-value: 0.125).Our findings suggest that even with a similar extent of social network, older adult caregivers are at a higher risk of loneliness, i.e., perceived social isolation or relational deficits, compared to non-caregivers.

EXAMINING CAREGIVER NETWORK STRUCTURE, COMPOSITION, AND COORDINATION FOR OLDER ADULTS WITH ALZHEIMER'S DISEASE William McConnell, Katherine Haggar, and María Ortega Hernández, Florida Atlantic University, Boca Raton, Florida, United States
Over half of the older adults with Alzheimer's disease and related dementias (ADRD) live in the community with informal caregivers whose unpaid assistance constitutes the majority of their care.Research and interventions targeting caregivers typically limit their focus to one primary caregiver, but many older adults with ADRD rely on a variety of interconnected kin, non-kin, and professional supporters.Little is known about the structure, composition, or consequences of these caregiver networks.To address this gap, we conducted a social network analysis (SNA) of the caregiver networks of 23 older adults with ADRD receiving outpatient services at a Memory Disorder Clinic.SNA data was obtained through detailed social network interviews conducted one-on-one with self-identified primary caregivers.We find that adults with ADRD have an average of 7.7 caregivers in their networks.Quantitative analyses demonstrate that caregiver network properties (including size, density, composition, and care coordination) vary with the context of caregiving (including living situation, level of functional impairment, and use of formal services).An average network includes a roughly even mix of informal caregivers (3.2 members) and professional caregivers (3.5), but they occupy different network positions and fill distinct supportive roles.For example, informal caregivers engage in frequent care coordination, but coordination is comparatively uncommon between formal caregivers.This interdisciplinary research advances beyond the dyadic level of analysis typical of most caregiving research to comprehensively measure caregiver networks.Further, we identify variations in caregiver networks and quantify network-based task-sharing and care coordination among informal and professional caregivers.Care networks are defined as the collection of individuals who provide support for older adults with health challenges.Although many older adults receive care from multiple caregivers, with varying intensities of caregiving, little is known about the structure of their care networks and whether or to what extent it changes over time.This study aims to examine the stability of care networks and the predictive effects of static and dynamic factors on patterns of caregiving networks.Using data from the National Health Aging Trends (NHAT) and National Study of Caregiving (NSOC), we examine the static and dynamic intrapersonal structures of care arrangements with regard to systematic continuity across 7 years.We utilize both Latent Profile Analysis and Latent Transition Analysis to identify different types of caregiving arrangements and patterns of transitions over time.Moreover, we use logistic regressions to examine how individual and time-varying factors affect those arrangements and transitions.The results show three groups of caregiving arrangements: 1) intense care with one caregiver, 2) moderate-level care with multiple caregivers, and 3) low-level care with multiple caregivers.Among the groups, moderate-level care with multiple caregivers is the most stable group.Moreover, static factors, such as gender and race, and dynamic factors, such as psychological resilience of care recipients, significantly impacts the probability of transitioning from low-level care to intense care over time.The findings highlight the utility of Latent Transition Analysis in caregiving networks, suggesting that patterns of caregiving outcomes should be understood as process as well as a condition.

THIS IS THE YEAR THAT WAS: THE BEST OF THE JOURNAL OF GERONTOLOGY BIOLOGICAL SCIENCES Chair: Gustavo Duque
The Journal of Gerontology Biological Sciences (JGBS) is one of the Gerontological Society of America publications.It publishes articles on the biological aspects of aging in areas such as translational gerontology, biomarkers of aging,